Testicular pain can be caused by various factors such as sudden injury, sexually transmitted infections, inflammation, and other medical emergencies. The pain can present as a dull ache affecting one or both testicles or the scrotum and may also trigger swelling. It is important to see your doctor for a proper diagnosis and treatment if you experience testicular pain lasting more than one hour.
By Able Health I Medically reviewed by Dr. Alireza Estedlal
Page last reviewed: February 2024 I Next review due: February 2026
What is testicular pain?
Testicular pain can occur in anyone with testicles or testes, regardless of age. Testicles are small reproductive organs resembling eggs located inside the scrotum, a thin sac of skin behind the penis. Individuals assigned male at birth (AMAB) typically have two testes, one on each side of the scrotum.
The pain can be felt in one or both testicles, but it might not originate from the testicles themselves. Sometimes, testicular pain can come from a different body area, such as the stomach or groin. This type of pain is known as referred pain.
Testicular pain may be categorised as either acute or chronic. Acute pain occurs abruptly, intensifies sharply, and lasts for a short time. In contrast, chronic pain develops gradually and persists for a long period. The testicles have several sensitive nerves, so the pain can be severe.
Contact your healthcare provider if you experience testicular pain lasting more than one hour. For intense testicular pain, you should go to the emergency room immediately. This is because it may indicate testicular torsion, a severe medical emergency.
Is it normal to have a testicle ache?
No, having a testicle ache is not normal.
The testicles are usually sensitive, and any trauma or impact can lead to temporary pain. However, it is important to consult a doctor if you experience persistent pain lasting over an hour. This may indicate a more severe problem affecting your testicles.
How can you know if testicular pain is serious?
Contact your doctor or go to the emergency room immediately if you experience any of the following:
Abrupt, extreme pain in one or both testicles.
Testicular pain accompanied by nausea, vomiting, and abdominal pain.
Swelling.
Testicular pain lasting more than an hour or not improving with rest or lying down.
Who is most at risk of testicular pain?
Anyone with testicles can experience testicular pain at any age. However, those who engage in heavy physical labour or contact sports (such as football, baseball, hockey, lacrosse, soccer, or martial arts) might be at greater risk of testicular pain.
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Testicle pain can have a wide range of causes. The cause may be clear if you have recently suffered an injury or accident during sports or exercise. However, in other instances, the reason for your pain might not be obvious.
Other common causes of testicular pain include:
Orchitis: Inflammation in one or both testicles caused by a bacterial or viral infection. The mumps virus is a major cause of orchitis among children. If mumps are the cause, swelling often begins 4 to 6 days after the onset of symptoms.
Inguinal (groin) hernia: Occurs when a section of the intestine pushes through a weak spot in the abdominal muscles surrounding the groin. While it is not always dangerous, it can be painful and might require immediate surgery in rare cases.
Epididymitis: Inflammation of the epididymis, a coiled group of tiny tubes carrying sperm from the testicles towards the sperm duct, and finally out of the body through orgasm. Epididymitis may be characterised by swelling and a hot feeling in the scrotum, and the infection can persist for weeks.
Spermatocele: Formation of a fluid-filled cyst in the epididymis around the testicle. Although they are noncancerous and usually painless, spermatoceles can grow larger and become uncomfortable.
Hydrocele: Accumulation of abdominal fluid in the scrotum near one or both testicles. This condition is more common, particularly in babies.
Hematocele: Accumulation of blood near one or both testicles, often following an injury.
Varicocele: A group of unusually enlarged veins in the scrotum. A varicocele can ache or cause discomfort during everyday activities. In most cases, lying down helps ease the pain.
Testicular torsion: Occurs due to twisting of the spermatic cord, which cuts off blood supply to the testicle, particularly the left one. This can lead to abrupt, sharp pain that can strike at any time. Testicular torsion is considered a medical emergency and requires surgery.
Kidney stones: Solid masses or crystals in the urinary system. The stones might obstruct the ureters (tubes draining urine from the kidney to the bladder) and cause discomfort in the testicles, groin, scrotum, and back. Small stones can pass during urination, but larger ones may require surgical removal.
Post-vasectomy pain: A vasectomy is a form of birth control involving surgery to seal the vas deferens (tubes carrying sperm). Some men experience testicular pain after a vasectomy due to increased pressure within the vas deferens or epididymis.
Testicular cancer: The most prevalent type of cancer in individuals AMAB aged between 15 and 35 years. It can manifest as a dull ache or discomfort in the testicles or groin.
Additional symptoms that may occur alongside testicular pain
Testicular pain might be accompanied by other symptoms:
Bruising: Bruising on the scrotum may occur following an injury to the testicles.
Nausea and vomiting: Feeling nauseous or vomiting could indicate various conditions causing testicular pain, such as orchitis, injury, and kidney stones.
Swelling: Swelling or lumps can form in the scrotum, making it look discoloured (purple, red, black, brown) or sometimes shiny. Swelling could indicate injury or infection.
Fever: A fever occurring alongside testicular pain usually indicates an infection.
Problems urinating: Kidney stones can lead to frequent urination, a burning feeling when urinating, or blood in the urine (haematuria).
Can testicular pain be caused by a sexually transmitted infection?
Yes, testicular pain is often a sign of certain sexually transmitted infections (STIs). STIs can affect various body parts, including the testicles, and may cause swelling or inflammation.
Types of STIs that might contribute to testicular pain include:
Diagnosing testicular pain involves reviewing your medical history and performing a physical examination. The doctor will thoroughly assess your testicles while you lie down and stand up. They are likely to ask the following questions during the examination:
When did the pain begin?
How long have your testicles been hurting?
Where exactly does it hurt?
Have you recently suffered an injury to your groin or abdomen?
Do any activities (such as going to the bathroom, masturbating, exercising, sitting, or having sex) improve or worsen your pain?
Additionally, the provider may inquire about your sexual history.
Other tests that might be ordered include:
Blood test: To rule out infections that could be causing testicular pain.
Urinalysis (urine test): To help rule out certain infections.
Ultrasound: If a lump in the testicle is suspected, an ultrasound may be ordered to detect testicular cancer.
Care and Treatment
How is testicular pain treated?
These remedies can help relieve testicular pain at home:
Using a cold compress or ice pack: Wrap a cold pack or ice in a towel and place it on the affected area intermittently during the day for at least 15 minutes at a time.
Placing a rolled-up towel beneath the scrotum while lying on your back.
Taking a warm bath.
Using nonsteroidal anti-inflammatory drugs (NSAIDs): Consult your doctor first, as NSAIDs aren’t recommended for everyone.
Talk to your provider if home remedies are ineffective. They can recommend medications to alleviate the pain, such as:
Antibiotics or anti-infective drugs: To treat bacterial or viral infections.
Tricyclic antidepressants (TCAs): Certain antidepressants, like amitriptyline, can help with nerve pain.
Can testicle pain go away on its own?
Depending on whether testicular pain is acute or chronic, it might or might not persist for long. If the pain is due to a minor injury, such as a sudden fall or hit, it should subside within about an hour. However, if it lasts longer or worsens, consider seeking immediate medical care.
Who treats testicular pain?
A primary care physician (PCP) can address testicular pain and help diagnose other underlying problems. If a more severe condition is suspected, the PCP might refer you to a specialist, such as:
Urologist: An expert who treats conditions affecting the urinary tract and reproductive system.
Nephrologist: A specialist in health conditions affecting the kidneys.
Is surgery needed for testicular pain?
The need for surgery to treat testicular pain depends on the underlying cause. In cases of emergency conditions such as testicular torsion or cancer, surgery is necessary.
Types of testicular pain surgeries include:
Testicular de-torsion: This emergency surgery helps uncoil the spermatic cord to restore normal blood supply to one or both testicles. The surgical area is then stitched to secure the testicles to the inner scrotum wall to avoid future occurrences of testicular torsion.
Hernia repair surgery: This procedure involves pushing the hernia back into the abdomen and reinforcing the abdominal wall with synthetic mesh or stitches.
Epididymectomy: The removal of the epididymis if it causes chronic pain. This is a rare procedure and is only recommended if other treatments are not effective.
Vasectomy reversal: If persistent testicular pain occurs after a vasectomy, the surgeon may recommend reversing the vasectomy to reduce pressure in the vas deferens or epididymis. This procedure is rare.
Shock wave lithotripsy: A minimally invasive procedure that uses high-energy shock waves to break kidney stones.
Microdenervation of the spermatic cord (MDSC): Involves cutting the nerves running through the spermatic cord to relieve testicular pain.
Orchiectomy: If testicular cancer is diagnosed or if medications and less invasive treatments fail, the surgeon may remove one or both testicles.
Can testicular pain be prevented?
The following approaches might help prevent testicular pain:
Addressing any issues that might cause testicular pain.
Wearing an athletic cup to protect the testicles when playing sports or engaging in rigorous activities.
When to Call the Doctor
When should testicular pain be treated by a healthcare provider?
Contact your doctor immediately if you experience testicular pain or swelling, particularly if the discomfort worsens or you feel unwell. If you notice symptoms of testicular torsion, ensure you go to the emergency room as soon as possible.
Additional Common Questions
Should I ignore testicular pain?
No, never ignore testicular pain. If the pain lasts more than an hour or worsens, seek immediate medical attention.
Can I still have children even after losing a testicle?
Yes. In most instances, one healthy testicle can produce adequate sperm for you to conceive children. You will still achieve and maintain normal erections, and testosterone levels will also remain the same.
Surgery to repair testicular torsion can reduce your sperm count or introduce antibodies into the system that impact sperm movement. If you have a history of childhood testicular torsion, your sperm count may be lower. Therefore, it is advisable to undergo a semen analysis if you are experiencing difficulties conceiving.
Can sitting for long periods cause testicular pain?
Yes, sitting for extended periods or crossing your legs can result in testicular pain. To minimise discomfort, you should sit less and instead stand or move more.
A Note from MD.co.uk
Testicular pain can occur suddenly and may be short-lived and potentially treatable at home. Alternatively, it can gradually worsen and last longer, indicating a more severe condition. As a general rule, if you experience sudden, severe testicular pain or pain that does not resolve after one hour, consult your doctor immediately.
While it may be uncomfortable to discuss such a sensitive body part, pain is the body’s indication that something is wrong. Seeking medical care is essential to ensure the best possible results.
